Оценка локального мукоцилиарного клиренса среднего носового хода при различных хирургических вмешательствах у больных с инородными телами верхнечелюстных пазух

Abstract

Examination of mucociliary clearance (MCC), evaluation of options for operative access to the maxillary sinus, from the position of MCC, regarding foreign bodies, are of increasing interest in otorhinolaryngology due to the ever-increasing incidence of this pathology, its artificial (secondary) nature—that is, arising against the background of known absence of any initial pathological changes. Objective. To study the local function of the MCC of the middle nasal passage in the postoperative period in patients with foreign bodies of the maxillary sinuses with various methods of surgical intervention on the maxillary sinus. Methods. The study involved 60 patients with foreign bodies of the maxillary sinuses and a comparison group of 60 healthy individuals. The patients were divided into 2 groups of 30 people according to the type of surgical access—trocar endoscopic maxillary sinusotomy, endonasal endoscopic antrostomy. The subjects underwent computed tomography (CT). For examination of local MCC, modern methods of mathematical analysis of data from high-speed video filming of a ciliary epithelium preparation were used. A questionnaire was used to subjectively assess nasal symptoms. The examinations were conducted in the early (1–14 days), late (1–6 months) postoperative period. Results. It was revealed that the normative local value of the MCC of the middle meatus in healthy individuals is 11,76 ± 3,01 Hz. In patients with foreign bodies of the maxillary sinus, the greatest influence on the initial local MCC, its violation in the postoperative period is exerted by changes in the middle meatus, cells of the ethmoid labyrinth, and mycetoma. The values of the local MCC of the middle meatus depend on the access to the maxillary sinus. Conclusion. Using methods for assessing local MCC, it is necessary to optimize access to the maxillary sinus with a wider use of techniques that do not affect the key area of the osteomeatal complex (transmaxillary endoscopic approach, access through the lower meatus).